ORDER FOR SUPPLIES OR SERVICES

Transcription

1 ORDER FOR SUPPLIES OR SERVICES Form Approved OMB No Expires Aug 31, 1992 Page 1 of 8 1. CONTRACT/PURCH ORDER NO. 2. DELIVERY ORDER NO. 3. DATE OF ORDER 4. REQUISITION/PURCH REQUEST NO. 5. PRIORITY D0-C9() N SEE BLK. 24 PR -00 / 6. ISSUED BY CODE N ADMINISTERED BY (If other than Block 6) CODE OFFICE OF NAVAL RESEARCH ONR, (703)696- ONE LIBERTY CENTER 875 NORTH RANDLOPH STREET, SUITE 1425 ARLINGTON, VA CONTRACTOR CODE FACILITY CODE 10. DELIVER TO FOB POINT BY (Date) (YYMMDD) See Page 2 13, MAIL INVOICES TO See Pages 3 and SHIP TO CODE N PAYMENT WILL BE MADE BY CODE OFFICE OF NAVAL RESEARCH ATTN PROGRAM OFFICER'S NAME, ONR CODE ONE LIBERTY CENTER 875 NORTH RANDOLPH STREET, SUITE 1425 ARLINGTON, VA DELIVERY FOB DEST OTHE R (See Schedule if other) 11. MARK OF BUSINESS IS SMALL 12. DISCOUNT TERMS SMALL DIS- ADVANTAG ED WOMEN- NET 30 DAYS OWNED MARK ALL PACKAGES AND PAPERS WITH CONTRACT OR ORDER NUMBER 16. TYPE OF ORDER DELIVERY This delivery order is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract. PURCHASE Reference your: See Page 2 Furnish the following on terms specified herein. ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME. NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED (YYMMDD) If this box is marked, supplier must sign Acceptance and return the following number of copies: 17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE SEE ATTACHED FINANCIAL ACCOUNTING DATA (FAD) SHEET(S) 18. ITEM NO. See Page SCHEDULE OF SUPPLIES/SERVICES This purchase order is written in accordance with the Small Business Innovative Research (SBIR) Program Authorized by 15 U.S.C. 638 See Page 2 for description of supplies and delivery schedule. 20. QUANTITY ORDERED/ACCEPTED 21. UNIT 22. UNIT PRICE 23. AMOUNT * If quantity accepted by the Government is same as quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle. 24. UNITED STATES OF AMERCIA 25. TOTAL See Page DIFFERENCES BY: CONTRACTING/ORDERING OFFICER 28. QUANTITY IN COLUMN 20 HAS BEEN 27. SHIPPING NO. 29. D.O. VOUCHER NO. INSPECTED RECEIVED ACCEPTED AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED 30. INITIALS PARTIAL 32. PAID BY 33. AMOUNT VERIFIED CORRECT FINAL FOR DATE SIGNATURE OF AUTHORIZED GOVERNMENT 31. PAYMENT 34. CHECK NUMBER REPRESENTATIVE 36. I certify this account is correct and proper for payment. COMPLETE PARTIAL DATE SIGNATURE AND TITLE OF CERTIFYING OFFICER FINAL 35. BILL OF LADING NO. 37. RECEIVED AT 38. RECEIVED BY 39. DATE RECEIVED 40. TOTAL CONTAINERS 41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO. DD FORM 1155, JAN 1998 PREVIOUS EDITION MAY BE USED

2 2 SUPPLIES OR SERVICES AND PRICES/COSTS ITEM NO. BASE (6 months) SUPPLIES / SERVICES QTY UNIT OF ISSUE 0001 The Contractor shall conduct research and provide reports in accordance with Paragraph 1 below. AMOUNT NSP 0001AA Progress Report 1 EA $30, AB Progress Report 1 EA $25, AC Final Report (In Accordance With Section 6, Electronic Submission of Summary Final Report (Phase I)) 1 EA ITEM 0001 FIRM FIXED PRICE OPTION I (3 months) ITEM SUPPLIES / SERVICES QTY UNIT AMOUNT NO. OF ISSUE 0002 The Contractor shall conduct research and provide NSP reports in accordance with Paragraph 2 below. 0002AA Progress Report 1 EA $15, AB Final Report 1 EA ITEM 0002 FIRM FIXED PRICE TOTAL FIRM FIXED PRICE: 1. Under Item 0001, the Contractor shall conduct research and provide reports in accordance with the section entitled, tasks through, of its proposal entitled, dated, submitted in response to SBIR topic, which section is incorporated herein by reference. 2. Under Option I (Item 0002), if exercised, the Contractor shall conduct research and provide reports in accordance with the section entitled, tasks through, of its proposal entitled, dated, submitted in response to SBIR topic, which section is incorporated herein by reference. 3. The Contractor shall accomplish the work during the period commencing from the date of contract award through nine (9) months. The additional three months are to allow the Government sufficient time to determine if the Option under Item Number 0002 should be exercised. Delivery of Subline Items shall be in accordance with the following schedule. Inspection and acceptance is at destination. Base Option I CLIN/SLIN Delivery Date CLIN/SLIN DELIVERY DATE 0001AA 60 DACA 0002AA Due 45 DAOE 0001AB 120 DACA 0002AB Due 90 DAOE 0001AC 180 DACA Note: Days after Contract Award (DACA) & Days After Option Exercise (DAOE)

3 3 4. INVENTION DISCLOSURES AND REPORTS The Contractor shall submit all invention disclosures and reports required by the Patent Rights clause of this contract to the Administrative Contracting Officer (ACO). The ACO (Refer to Block 7 of the DD Form 1155 for POC information) will forward invention disclosures and reports directly to Corporate Counsel (Code 00CC), Office of Naval Research, Department of the Navy, 875 North Randolph Street, Suite 1425, Arlington, VA Corporate Counsel will return the reports along with a recommendation to the ACO. Corporate Counsel represents the Contracting Officer regarding invention reporting matters arising under this purchase order. 5. ONR SPECIAL SMALL BUSINESS INNOVATION RESEARCH (SBIR) REQUIREMENTS (DEC 88) A minimum of two-thirds of the SBIR Project shall be carried out by the proposing firm. The primary employment of the principal investigator shall be with the Contractor at the time of award and during the conduct of the proposed effort. Primary employment means that more than one-half of the principal investigator s time is spent with the Contractor. Deviations from the above requirements shall be approved in writing by the Contracting Officer. The research or research and development work under this contract shall be performed by the Contractor in the United States. United States means the several states, the Territories and possessions of the United States, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, the Trust Territory of the Pacific Islands, and the District of Columbia. 6. ELECTRONIC SUBMISSION OF SUMMARY FINAL REPORT (PHASE I) You must submit an electronic NONPROPRIETARY summary of your final report directly to the Navy SBIR/STTR website at To submit this report, select Submission, then select Submit a Phase I or II Summary Report, then select Begin Submission Process. Enter your firm name and the password used to submit proposals to the DoD Proposal Submission website. Select Summary Report and Add a New Report. Follow the remaining instructions given on the submission website. Additional guidance on payment issues, progress and final report formats, Phase II plans, and other information on SBIR and STTR programs can be found at the Navy SBIR/STTR website at 7. INSTRUCTIONS FOR PAYMENT The Office of Naval Research will utilize the new DoD Wide Area Workflow Receipt and Acceptance (WAWF) system. This web based system located at provides the technology for government contractors and authorized Department of Defense (DoD) personnel to generate, capture and process receipt and payment-related documentation in a paperless environment. Invoices for supplies/services rendered under this contract shall be submitted electronically through WAWF. Submission of hard copy DD250/invoices will no longer be accepted for payment. It is recommended that the person in your company designated as the Central Contractor Registration (CCR) Electronic Business (EB) Point of Contact and anyone responsible for the submission of invoices, use the online training system for WAWF at The Vendor, Group Administrator (GAM), and sections marked with an asterisk in the training system should be reviewed. Vendor Quick Reference Guides are also available at

4 4 The most useful guides are Getting Started for Vendors, WAWF Vendor Guide, and either Creating a Combo Receiving Report and Invoice or Creating a 2-in-1 Service Invoice ; use the latter if the invoice is for services only. The designated CCR EB point of contact is responsible for activating the company s CAGE code on WAWF by calling Once the company is activated, the CCR EB will self-register on the WAWF and follow the instructions for a group administrator. After the company is set-up on WAWF, any additional persons responsible for submitting invoices must self-register at the WAWF: The designated CCR EB point of contact is responsible for activating the company s CAGE code on WAWF by calling Once the company is activated, the CCR EB will self-register on the WAWF and follow the instructions for a group administrator. After the company is set-up on WAWF, any additional persons responsible for submitting invoices must self-register at the WAWF The following required information should automatically fill-in via WAWF; if it does not fill-in, include the following: IssueBy DODAAC: N00014 Admin DODAAC: [Use the 6 character ADMINISTERED BY CODE as listed on page one of the award document] Pay DODAAC: [Use the 6 character PAYMENT WILL BE MADE BY CODE as listed on page one of the award document] Fill-in the following additional information: Service Acceptor DODAAC: N00014 (Note this line is required only with Invoice as 2-in-1 (Services Only) type invoices) Ship To Code DODAAC: [Use the 6 character SHIP TO CODE as listed on page one of the award document] (Note this line is required only with "Invoice and Receiving Report (Combo)" type invoices) The following additional information may need to be filled in: LPO DODAAC: N00014 (Note - this line is required only when the the PAYMENT WILL BE MADE BY DODAAC begins with an N ) After self-registering and logging on to the WAWF system, click on the plus sign next to the word Vendor and then click on the Create New Document link. Enter the contract number, cage code, and Pay DODAAC (above) and hit submit. Select either the: Invoice as 2-in-1" (Services Only) for services/r&d (can include incidental supplies) or "Invoice and Receiving Report (Combo)" for supplies/services) invoice type within WAWF-RA. Both types of invoices fulfills any requirement for submission of the Material Inspection and Receiving Report, DD Form 250. Back up documentation, 5MB limit, can be included and attached to the invoice in WAWF under the Misc Info tab. Fill-in all applicable information under each tab. If any of your reports are above 5 MB then only submit the first several pages through this system. Attachments created in any Microsoft Office product are attachable to the invoice. Reports attached in WAWF will go to the SBIR Program Manager only. Reports must still be submitted to the Program Officer as directed under Item number 8.

5 5 Take special care when you enter Line Item information - the Line Item tab is where you will detail your request for payment and material/services that were provided based upon the contract. Be sure to fill in the following two informational items exactly as they appear in the contract: 1) Item Number: If the contract schedule has more than one ACRN listed as sub items under the applicable Contract Line Item Number (CLIN), use the 6 character separately identified Sub Line Item Number (SLIN) (e.g. 0001AA) or Informational SLIN (e.g ), otherwise use the 4 character CLIN (e.g. 0001). 2) ACRN: Fill-in the applicable 2 alpha character ACRN that is associated with the SLIN or CLIN. (Note DO NOT INVOICE FOR MORE THAN IS STILL AVAILABLE UNDER ANY ACRN). After all required information is included, click on the Submit button under the Header tab. A separate invoice will be prepared for each of the 3 increments of the payments due as listed under 3 of this contract. The 3 rd invoice must be submited as a final invoice (select Y in the Final Invoice block). Do not combine the payment claims for services under this contract. Helpful Note: Shipment Number format should be three alpha and 4 numeric (e.g., SER0001). Note: The contractor shall submit invoices for payment per contract terms and the Government shall process invoices for payment per contract terms. If you have any questions regarding the WAWF, please contact the DoN WAWF Assistance Line at WAWF (9293). 8. CLAUSES FAR Clauses Incorporated by Reference (FEB 1998): This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address: Federal Acquisition Regulation (FAR) (48 CFR Chapter 1) Clauses and Department of Defense FAR Supplement (DFARS) (48 CFR Chapter 2) (SEP 2002) FAR Central Contractor Registration (OCT 2003) FAR Protecting the Government s Interest when Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (JAN 2005) FAR Defense Priority and Allocation Requirements (SEP 1990) FAR Terms and Conditions Simplified Acquisitions (Other Than Commercial Items) (APR 2005) FAR Order of Precedence Uniform Contract Act (OCT 1997) FAR Option for Increased Quantity Separately Priced Line Item (MAR 1989) FAR (Insert 9 months after the Order is executed ) Notice of Total Small Business Set-Aside (JUN 2003), and Alternate I (JUN 2003) FAR Convict Labor (JUN 2003) FAR Prohibition of Segregated Facilities (FEB 1999) FAR Equal Opportunity (APR 2002)

6 6 FAR Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era. and Other Eligible Veterans (DEC 2001) FAR Affirmative Action for Workers with Disabilities (JUN 1998) FAR Employment Reports on Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans (DEC 2001) FAR Restrictions on Certain Foreign Purchases (MAR 2005) FAR Patent Rights Retention by Contractor (Short Form) (JUN 1997) FAR Rights in Data SBIR Program (MAR 1994) FAR Payments under Fixed-Price Research and Development Contracts (APR 1984) FAR Limitation on Withholding of Payments (APR 1984) FAR Assignment of Claims (JAN 1986) and Alternate I (APR 1984) FAR FAR Prompt Payment (OCT 2003) (The words the 30 th day are inserted in lieu of the 7 th day at (a)(5)(i). Payment by Electronic Funds Transfer Central Contractor Registration (OCT 2003) FAR Disputes (JULY 2002) FAR Protest After Award (AUG 1996) FAR Stop Work Order (AUG 1989) FAR Changes Fixed Price (AUG 1987) and Alternate V (APR 1984) FAR Subcontracts for Commercial Items (DEC 2004) FAR Inspection of Research and Development (Short Form) (APR 1984) FAR F.o.b. Destination (NOV 1991) FAR Termination for Convenience of the Government (Fixed Price) (Short Form) (APR 1984) FAR Computer Generated Forms (JAN 1991) DFARS Control of Government Personnel Work Product (APR 1992) DFARS Alternate A (NOV 2003) DFARS Secondary Arab Boycott of Israel (JUN 2005) DFARS Rights in Bid or Proposal Information (JUN 1995) DFARS DFARS Identification And Assertion Of Use, Release, Or Disclosure Restrictions (JUN 1995) Rights in Noncommercial Technical Data and Computer Software Small Business Innovation Research (SBIR) Program (JUN 1995) DFARS Validation of Asserted Restrictions Computer Software (JUN 1995) DFARS Technical Data Withholding of Payment (MAR 2000) DFARS Patents Subcontracts (APR 1984) DFARS Declaration of Technical Data Conformity (JAN 1997) DFARS Validation of Restrictive Markings on Technical Data (SEP 1999) DFARS Patents Reporting of Subject Inventions (APR 1990) DFARS Supplemental Cost Principles (DEC 1991) DFARS Electronic Submission of Payment Requests (JAN 2004) DFARS Animal Welfare (DEC 1991) DFARS Final Scientific or Technical Report (NOV 2004) DFARS Postaward Conference (DEC 1991) DFARS Pricing of Contract Modifications (DEC 1991) DFARS Material Inspection and Receiving Report (MAR 2003)

7 7 9. PURCHASE ORDER DATA REQUIREMENTS LIST INSTRUCTIONS FOR DISTRIBUTION DISTRIBUTION OF PROGRESS REPORTS The minimum distribution for Progress Reports is as follows: ADDRESSEE Program Officer: Note: Send to Prog Officer when SBIR Phase I SBIR Program Manager Cathy Nodgaard nodgaac@onr.navy.mil Note: Send to SBIR Program Manager only if ONR SBIR Phase I Administrative Contracting* Fax: DODAAC NUMBER OF COPIES CODE UNCLASSIFIED / LIMITED AND CLASSIFIED N N *Send only a copy of the transmittal letter to the Administrative Contracting Officer; do not send actual reports to the Administrative Contracting Officer. DISTRIBUTION OF FINAL TECHNICAL REPORTS (A SF-298 must accompany the final technical report) ADDRESSEE OFFICE OF NAVAL RESEARCH ATTN:, ONR CODE: ONE LIBERTY CENTER Error! Reference source not found., SUITE REF: N SBIR PROGRAM MANAGER ATTN: CATHY NODGAARD, CODE 364 OFFICE OF NAVAL RESEARCH 875 N RANDLOPH STREET, SUITE 1425 ARLINGTON, VA Phone: (703) nodgaac@onr.navy.mil REF: N ADMINISTRATIVE CONTRACTING OFFICER* Fax: DODAAC CODE N00014 N00014 NUMBER OF COPIES UNCLASSIFIED / LIMITED AND CLASSIFIED 1 w/sf w/sf w/sf-298

8 8 DEFENSE TECHNICAL INFORMATION HJ w/sf-298 CENTER 8725 JOHN J. KINGMAN RD, SUITE 0944 FORT BELVOIR, VA ATTN: Pat Mawby pmawby@dtic.mil DIRECTOR, NAVAL RESEARCH LAB ATTN: CODE OVERLOOK AVENUE, SW WASHINGTON, D.C reports@library.nrl.navy.mil N w/sf-298 * Send only a copy of the transmittal letter to the Administrative Contracting Officer; do not send actual reports to the Administrative Contracting Officer. ELECTRONIC SUBMISSIONS OF TECHNICAL REPORTS IS PREFERRED AND ENCOURAGED. ELECTRONIC SUBMISSION SHOULD BE SENT TO THE ADDRESSES PROVIDED IN THE ABOVE TABLE, HOWEVER PLEASE NOTE THE FOLLOWING: Only Unlimited/Unclassified document copies may be submitted by . Unclassified/Limited has restricted distribution and a classified document (whether in its entirety or partially) is to be distributed in accordance with classified material handling procedures. Electronic submission to DIRECTOR, NAVAL RESEARCH LAB, shall be unclassified/unlimited reports and 30 pages or less. If unclassified and more than 30 pages, hardcopies of reports must be mailed. Electronic submission to DTIC shall be unclassified/unlimited reports. If submission is for limited documents, please send them in on a disk or sign up for DTIC s web-based document submission system at DTIC prefers.pdf,.tif, and.ps files; however, other formats will also be accepted. NOTE: DTIC can no longer accept the following file types via password protected, zipped or compressed files, file with the extensions: *.vbs, *.cmd, *.exe, *.bat, *.com, *.mp3, *.eml and *.dll. All reports, briefs, technical documents, etc. submitted to the Government under this award should contain the following legend: SBIR DATA RIGHTS Topic Number: Award No.: Contractor Name: Contractor Address: The Government's rights to use, modify, reproduce, release, perform, display, or disclose technical data or computer software marked with this legend are restricted as provided in paragraph (b)(4) of DFARS 252-

9 , Rights in Noncommercial Technical Data and Computer Software--Small Business Innovative Research (SBIR) Program. 10. ATTACHMENTS a. Report Documentation Page (SF 298) 1 page b. Financial Accounting Data (FAD) Sheet(s)

10 REPORT DOCUMENTATION PAGE Form Approved OMB No Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports ( ), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 2. REPORT TYPE 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) 11. SPONSOR/MONITOR S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Distribution authorized/limited to U.S. Government Agencies only; report contains proprietary data produced under an SBIR award. Other requests shall be referred to the performing organization in Block 7 of this form. 13. SUPPLEMENTARY NOTES 14. ABSTRACT This report was developed under an SBIR award for Solicitation topic # SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18